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Steroid-induced psychosis

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https://www.readbyqxmd.com/read/27016478/post-steroid-neuropsychiatric-manifestations-are-significantly-more-frequent-in-sle-compared-with-other-systemic-autoimmune-diseases-and-predict-better-prognosis-compared-with-de-novo-neuropsychiatric-sle
#1
REVIEW
Yuka Shimizu, Shinsuke Yasuda, Yuki Kako, Shin Nakagawa, Masatoshi Kanda, Ryo Hisada, Kazumasa Ohmura, Sanae Shimamura, Haruki Shida, Yuichiro Fujieda, Masaru Kato, Kenji Oku, Toshiyuki Bohgaki, Tetsuya Horita, Ichiro Kusumi, Tatsuya Atsumi
In patients with systemic lupus erythematosus (SLE), neuropsychiatric (NP) symptoms sometimes occur after administration of corticosteroids, making differential diagnosis between NPSLE and steroid-induced psychosis challenging for clinicians. The aim of this study was to clarify the characteristics of post-steroid NP disease (PSNP) in patients with SLE. Clinical courses of 146 patients with SLE and 162 with other systemic autoimmune diseases, all in the absence of NP manifestations on admission, were retrospectively analyzed...
August 2016: Autoimmunity Reviews
https://www.readbyqxmd.com/read/26644319/sustained-corticosteroid-induced-mania-and-psychosis-despite-cessation-a-case-study-and-brief-literature-review
#2
REVIEW
Mary Gable, Dwayne Depry
OBJECTIVE: Corticosteroids generally result in short-lasting neuropsychiatric symptoms following cessation, but the following case highlights an unusually long-lasting course of symptoms in a patient following near immediate cessation of medication, despite medication management and electroconvulsive therapy. The case presentation will be followed by a discussion of the presentation, treatment, and management of steroid-induced neuropsychiatric symptoms. METHODS: The patient was followed from symptom onset to resolution...
2015: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/26594001/multiple-infectious-pseudoaneurysms-an-autopsy-case
#3
Shuntaro Abe, Yoshikatsu Okada, Takako Sato, Koichi Suzuki
A 47-year-old Japanese woman died unexpectedly 11 days after admission due to acute cerebellar infarction. The patient had a history of Sjögren syndrome with long-term steroid therapy, hypertension, thalamic infarction and amphetamine psychosis. Multiple pseudoaneurysms in both the aorta and coronary artery were found at autopsy, and one located in the aortic root had ruptured into the pericardium resulting in sudden unexpected death. The detailed examination suggested that the pseudoaneurysms resulted from microbial infection to the arterial wall via the vasa vasorum...
November 2015: Legal Medicine
https://www.readbyqxmd.com/read/26488344/acute-psychosis-in-the-course-of-treatment-of-acute-adrenal-crisis-with-hydrocortisone-in-the-patient-with-secondary-adrenal-insufficiency-a-case-study
#4
Jan Brykalski, Lucyna Papierska, Maria Załuska
OBJECTIVES: Presentation of the risk of psychosis induced by the treatment of adrenal crisis with high doses of hydrocortisone. METHODS: A case analysis in the context of the literature. RESULTS: There are reported psychoses in the patients with adrenal hypofunction and hyperfunction. Psychoses following implementation of substitution with small doses of corticosteroids due to adrenal insufficiency were also observed. The hypereactivity of the glucocorticoid receptor is supposed mechanism...
2015: Psychiatria Polska
https://www.readbyqxmd.com/read/25833261/steroid-psychosis-caused-by-perioperative-steroid-replacement-for-pituitary-adenoma-a-case-report
#5
Katsuhiro Mizutani, Masahiro Toda, Ryogo Kikuchi, Hiroyuki Uchida, Kazunari Yoshida
Steroid psychosis is a frequent complication of steroid treatment. Although perioperative steroid replacement therapy is generally administered in patients undergoing pituitary surgery, there are no previous reports concerning the development of steroid psychosis after perioperative steroid replacement therapy following pituitary surgery. We herein report a case of steroid psychosis induced by perioperative steroid replacement therapy for pituitary surgery. A 35-year-old man presented with a visual disturbance that had persisted for 1 year...
2015: Keio Journal of Medicine
https://www.readbyqxmd.com/read/24943696/psychiatric-adverse-effects-of-pediatric-corticosteroid-use
#6
REVIEW
Linda B Drozdowicz, J Michael Bostwick
Corticosteroids, highly effective drugs for myriad disease states, have considerable neuropsychiatric adverse effects that can manifest in cognitive disorders, behavioral changes, and frank psychiatric disease. Recent reviews have summarized these effects in adults, but a comprehensive review on corticosteroid effects in children has not been published since 2005. Here, we systematically review articles published since then that, we find, naturally divide into 3 main areas: (1) chronic effects of acute prenatal and neonatal exposure associated with prematurity and congenital conditions; (2) immediate behavioral effects of acute exposure via oncological protocols; and (3) acute behavioral effects of sporadic use in children and adolescents with other conditions...
June 2014: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/24929259/psychosis-in-children-with-systemic-lupus-erythematosus-the-role-of-steroids-as-both-treatment-and-cause
#7
Orna Alpert, Raman Marwaha, Hsiang Huang
Steroids may both be a cause of and treatment for pediatric patients with systemic lupus erythematosus (SLE) presenting with psychotic symptoms. We present two cases demonstrating that careful histories (including prior steroid exposure) and the use of biomarkers can help guide the management of children with SLE presenting with psychosis.
September 2014: General Hospital Psychiatry
https://www.readbyqxmd.com/read/24796878/evaluation-of-spatial-memory-and-locomotor-activity-during-hypercortisolism-induced-by-the-administration-of-dexamethasone-in-adult-male-rats
#8
Tevfik Yılmaz, Öznur Gedikli, Mehmet Yildirim
In neurosurgery practice glucocorticoids are commonly used. Steroids may have central nervous system side effects affecting whole body, including steroid-induced mental agitation and psychosis. In experimental and clinical studies conducted by using dexamethasone (DEX), it has been reported that DEX adversely affects learning and memory skills. Unfortunately, there are yet no clinically accepted clinical approaches to prevent DEX-induced cognitive dysfunction. In this experimental study it was aimed to investigate the effect of chronic DEX administration on learning-memory and locomotor behaviors in adult male Sprague Dawley rats...
January 21, 2015: Brain Research
https://www.readbyqxmd.com/read/24701071/olanzepine-induced-neuroleptic-malignant-syndrome-in-a-case-of-multiple-sclerosis
#9
Deepak Hanumanthaiah, Kumar Ramanathan
Suspicion of neuroleptic malignant syndrome (NMS) is a frequent cause of emergent psychiatric consultation. Despite early recognition, NMS has remained a syndrome that causes high rates of morbidity and mortality. A 25-year-old male with multiple sclerosis presented to the accident and emergency department and E with ataxia. He was started on steroids. On the third day, he became tearful and anxious. A diagnosis of multiple sclerosis-induced psychosis was made and he was started on olanzepine 2.5 mg BD. On the sixth day the patient was tachypneic and had tachycardia...
March 2014: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/24553497/strategies-to-prevent-the-neuropsychiatric-side-effects-of-corticosteroids-a-case-report-and-review-of-the-literature
#10
REVIEW
Stephen West, Chris Kenedi
PURPOSE OF REVIEW: The use of corticosteroids is increasing, and while the physical complications of their use are well known, the neuropsychiatric consequences are not. This review focuses on preventing these neuropsychiatric complications. Although there are limited data on this subject, it is a problem that clinicians face on a regular basis. RECENT FINDINGS: The incidence of neuropsychiatric complications rises rapidly once the daily dose of prednisone is greater than 40 mg...
April 2014: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/24394681/chicken-or-the-egg-anorexia-nervosa-and-systemic-lupus-erythematosus-in-children-and-adolescents
#11
Alene Toulany, Debra K Katzman, Miriam Kaufman, Linda T Hiraki, Earl D Silverman
Systemic lupus erythematosus (SLE) frequently has neuropsychiatric involvement including affective disorders, psychosis, and cognitive dysfunction. Evidence suggests that anorexia nervosa (AN) in adolescents with SLE may be triggered by steroid-induced changes in weight and body shape. We propose that AN may be another manifestation of neuropsychiatric SLE and should be considered in this patient population. A retrospective chart review identified 7 children/adolescents diagnosed with SLE and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria for AN, restrictive subtype, at the Hospital for Sick Children in Toronto between January 1989 and January 2011...
February 2014: Pediatrics
https://www.readbyqxmd.com/read/24387654/a-case-of-central-nervous-system-lupus-in-succession-to-lupus-peritonitis-a-difficulty-in-the-differential-diagnosis-between-lupus-psychosis-and-steroid-induced-psychosis
#12
Miki Murata, Akira Hashiramoto, Toru Yamaguchi, Chihiro Takabayashi, Takashi Yamane, Yasushi Miura, Hisamitsu Baba, Kazuo Chihara, Shunichi Shiozawa
Abstract A 55-year-old woman with well-controlled systemic lupus erythematosus (SLE) suffered from the abrupt onset of massive intractable ascites, which did not respond to conventional diuretic therapy. While treatment with methylprednisolone pulse therapy ameliorated this lupus peritonitis, neuropsychiatric symptoms then appeared. After a diagnosis of the central nervous system (CNS) lupus, pulse therapy was continued and the patient recovered from the lupus psychosis. We discuss the differential diagnosis between CNS lupus and steroid-induced psychosis with particular references to recent diagnostic methods for CNS lupus...
September 2004: Modern Rheumatology
https://www.readbyqxmd.com/read/24226529/differential-diagnosis-of-steroid-dependent-nephrotic-syndrome-with-psychosis-practical-and-ethical-issues
#13
C K Westergaard, C J Nowinski, J J Sweet
The present case illustrates practical and ethical issues that can be encountered by clinical psychologists providing consultation services in medical settings. The neuropsychological consultation service was asked to evaluate a 22-year-old male with psychosis, steroid-dependent nephrotic syndrome, and a family history of schizophrenia. MRI revealedmarked cortical atrophy. Clinical findings were consistent with (1) steroid inducedapparent atrophy, which has been shown to be reversible with withdrawal of steroids; (2) uremia secondary to steroid withdrawal; (3) cortical atrophy, found in some schizophrenics; or (4) an atypical, diffuse degenerative disorder...
March 1996: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/24097913/combination-of-inhaled-corticosteroid-and-bronchodilator-induced-delirium-in-an-elderly-patient-with-lung-disease
#14
Jason M Moss, Debra W Kemp, Jamie N Brown
Steroid psychosis has been well described with oral glucocorticoids, however, our search of the literature did not identify an association between delirium and the combination of inhaled glucocorticoids and long-acting beta-agonists. We describe the occurrence of delirium with the combination of an inhaled glucocorticoid and bronchodilator. An elderly male described confusion and hallucinations within 1 week after initiation of budesonide/formoterol for chronic obstructive pulmonary disease. The combination inhaler was discontinued with resolution of symptoms...
February 2014: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/24062647/altered-gamma-oscillations-during-pregnancy-through-loss-of-%C3%AE-subunit-containing-gaba-a-receptors-on-parvalbumin-interneurons
#15
Isabella Ferando, Istvan Mody
Gamma (γ) oscillations (30-120 Hz), an emergent property of neuronal networks, correlate with memory, cognition and encoding. In the hippocampal CA3 region, locally generated γ oscillations emerge through feedback between inhibitory parvalbumin-positive basket cells (PV+BCs) and the principal (pyramidal) cells. PV+BCs express δ-subunit-containing GABA(A)Rs (δ-GABA(A)Rs) and NMDA receptors (NMDA-Rs) that balance the frequency of γ oscillations. Neuroactive steroids (NS), such as the progesterone-derived (3α,5α)-3-hydroxy-pregnan-20-one (allopregnanolone; ALLO), modulate the expression of δ-GABA(A)Rs and the tonic conductance they mediate...
2013: Frontiers in Neural Circuits
https://www.readbyqxmd.com/read/23062764/inappropriate-treatments-for-patients-with-cognitive-decline
#16
REVIEW
A Robles Bayón, F Gude Sampedro
INTRODUCTION: Some treatments are inappropriate for patients with cognitive decline. We analyse their use in 500 patients and present a literature review. DEVELOPMENT: Benzodiazepines produce dependence, and reduce attention, memory, and motor ability. They can cause disinhibition or aggressive behaviour, facilitate the appearance of delirium, and increase accident and mortality rates in people older than 60. In subjects over 65, low systolic blood pressure is associated with cognitive decline...
November 2014: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/23062459/-homicide-and-acute-cortico-induced-psychosis-a-case-report
#17
G Airagnes, C Rouge-Maillart, J-B Garre, B Gohier
BACKGROUND: Since their commercialization in 1950, the first psychiatric side effects of steroids have been reported. Today, steroids have become an important therapeutic tool in many diseases, but pharmacological mechanisms responsible for their side effects are still little known. The neuropsychiatric side effects concern 15% of patients while severe reactions occur in 5% of cases, mostly as acute psychotic episodes such as delusion. Serious forensic risks in this context are poorly documented and underestimated...
October 2012: L'Encéphale
https://www.readbyqxmd.com/read/22763760/steroid-psychosis-a-review-for-neurosurgeons
#18
REVIEW
Donald A Ross, Justin S Cetas
Steroids are beneficial in neurological illness, but have many serious side effects. Having observed several patients with severe steroid psychoses, which greatly prolonged their hospitalizations, the authors sought to improve understanding of this entity. A literature review was conducted. The incidence of severe psychiatric symptoms was estimated in a meta-analysis of 2,555 patients to be 5.7 % and the incidence of any psychiatric symptoms was 18.6 % in patients receiving >80 mg/day of prednisone (12 mg/day dexamethasone)...
September 2012: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/22424158/the-neuropsychiatric-complications-of-glucocorticoid-use-steroid-psychosis-revisited
#19
REVIEW
Amelia N Dubovsky, Sheila Arvikar, Theodore A Stern, Lloyd Axelrod
BACKGROUND: Glucocorticoids are widely prescribed for a variety of diseases and are known to cause neuropsychiatric as well as somatic side effects. OBJECTIVE: This article will review the incidence, clinical characteristics, course, and treatment of neuropsychiatric effects of glucocorticoids. METHODS: We performed a literature review of the neuropsychiatric complications of glucocorticoids using the PubMed database. RESULTS: The neuropsychiatric effects of glucocorticoids involve affective, behavioral, and cognitive manifestations...
March 2012: Psychosomatics
https://www.readbyqxmd.com/read/22343095/the-clinical-characteristics-of-lupus-related-protein-losing-enteropathy-in-hong-kong-chinese-population-10-years-of-experience-from-a-regional-hospital
#20
S T Law, K M Ma, K K Li
OBJECTIVE: The aim of our study was to investigate systemic lupus erythematosus (SLE) related protein-losing enteropathy (PLE) in the following areas: clinical features, laboratory, endoscopic and imaging characteristics, treatment and outcome. METHOD: A retrospective analysis was performed. RESULTS: From 2001 to 2010, 48 patients had SLE related PLE and their clinical characteristics were: age 40.8 ± 14.3 years, male-to-female ratio 1:8...
July 2012: Lupus
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